| Penn Dental Medicine | |
|
240 S 40th St Philadelphia PA 19104-6030 | |
| (215) 898-4615 | |
| Not Available |
| Full Name | Penn Dental Medicine |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 240 S 40th St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Alisa G Kauffman (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2157462944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penn Dental Medicine 240 S 40th St Philadelphia PA 19104-6030 Ph: () - | Penn Dental Medicine 240 S 40th St Philadelphia PA 19104-6030 Ph: (215) 898-4615 |
| NPI Number | 1205234382 |
|---|---|
| Provider Enumeration Date | 12/05/2014 |
| Last Update Date | 12/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205234382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS038838 (Pennsylvania) | Primary |
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